Western Canada Connected Vehicle Workshop April 14, 2015 EVENT REGISTRATION FORM Workshop title: Western Canada Connected Vehicle Workshop: Preparing Road Authorities for the Future Organizer: Workshop date: Primary Sponsor: Workshop venue: ITS Canada and the University of Alberta Centre for Smart Transportation Tuesday, April 14, 2015 - 8:30 am to 5:30 pm MDT University of Alberta & NSERC University of Alberta, Solarium, 2nd Floor (Maier Learning Centre), Engineering Teaching and Learning Complex, Edmonton, AB, Canada www.its.ualberta.ca Workshop website: Name: Title: Organization: Address: City Province: Postal Code: Tel: Email: Registration type: (circle all that apply) Type ITS Canada Member Non-member $40 $60 $200 $300 - Breakfast sponsor (includes 2 registrations) $400 $500 - Morning or afternoon break (includes 1 registration) $250 $300 - Lunch sponsor (includes 3 registrations and 5-minute speaking opportunity) $750 $1000 - Private company speaker/presenter (includes 2 registrations) $500 $750 Delegate only: Exhibitor (includes: Table-top exhibit space and 1 registration): Sponsor Categories: ITS Canada, 6975 Meadowvale Town Centre Circle #400, Mississauga, ON L5N 2V7, Tel: 905-593-0947/Fax: 905-593-0949 www.itscanada.ca All prices quoted exclude HST. * If you are interested in being a SPEAKER at our workshop, kindly get in touch with Mr. Rob Shirra at rob.shirra@itscanada.ca ** If you are interested in becoming a member of ITS Canada, kindly get in touch with Janneke van der Zee-Poelking at janneke@itscanada.ca Registration is accepted on a first come first served basis, as space is limited. Payment can be made via cheque payable to ITS Canada or by credit card. Please return completed form to Janneke van der Zee-Poelking at janneke@itscanada.ca or by fax to 905-593-0949. ITS Canada, 6975 Meadowvale Town Centre Circle #400, Mississauga, ON L5N 2V7, Tel: 905-593-0947/Fax: 905-593-0949 www.itscanada.ca
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